What You Should Know About ICD-10

The last five years have seen significant changes in how the U.S. health care system works. Federally-mandated reforms have drastically altered the ways all health care organizations – from small single provider practices to large health systems – handle patient data, record keeping, communication and privacy. The latest reform scheduled to take effect on October 1 will change how those same organizations record diagnoses and in-patient procedures.

What is ICD?

Currently, health care professionals rely on International Classification of Diseases (ICD) codes to record patient health conditions and procedures used to treat those conditions. Those codes represent a common language used by providers and payers (such as insurers and the Federal government) to both classify conditions and to determine accurate payment for services. In addition to this, public health officials use data recorded using ICD codes to track health trends and health-related threats.

The current set, known as ICD-9 has been in place since 1979 and is comprised of approximately 13,000 diagnosis codes and 4,000 procedure codes. ICD-9 critics consider those codes to be antiquated, given that they are over 30 years old and lack the detail needed to accurately describe modern diagnoses, medical services and procedures.

Changes and Challenges

ICD-10 will increase the number of diagnosis codes to 69,000 and procedure codes to 72,000. While this is good news for those seeking more detailed, accurate reporting and billing of health care conditions, it represents roughly a five-fold increase in available options and will almost certainly result in potential slowdowns in the system as heath care organizations struggle to adapt to changes in their office flow, health data reporting and billing.

In addition to this, patients will likely see changes in their health care records and billing statements as the new codes are implemented. While this may alarm some, it is part of the Federal mandate and as such, is required of all health care organizations.

Benefits of the New System

Hospitals and practices may initially struggle with implementing ICD-10. However, the new data resulting from this effort will likely benefit patients in the long run: increasing patient safety, improving outcomes, improving our public health system, and leading to more accurate billing. Furthermore, once ICD-10 is implemented, the United States will join the other 150+ countries worldwide that have already adopted it, improving our ability to track health data not just nationally, but also internationally. This represents a true benefit in a world where dangerous epidemics transcend borders in a matter of hours.

During this transition to ICD-10 you may have questions about information shown on your patient summary, diagnosis list or billing statements.